spironolactone is not popular for a lot of reasons.
Primarily, it is the agent most likely to produce gynecomastia, as it is a SARM.
Roughly, the rates of gyno are as follows:
1)
finasteride 1 mg - <1% (case reports only)
ref,
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2) Finasteride 5 mg - 0.3-4.5%
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3) Dutasteride 0.5 mg - 1.8-2.3%
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4) Darolutamide 100-900 mg twice daily - 2.4%
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5) Spironolactone 25-50 mg - 7%
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6) Spironolactone 75-100 mg - 17%
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7) Cyproterone - up to 18%
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8) Flutamide - up to 19%
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9) Enzalutamide - 49%
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10) Spironolactone ≥ 150 mg - 52%
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11) Bicalutamide - 60%
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Of interest, darolutamide is the strongest antiandrogenic agent on the list yet has the 3rd lowest rate of gyno after finasteride and dutasteride, and that's for daro in massive oral doses.
This has to do primarily with the fact that daro doesn't cross the blood brain barrier and thus doesn't f*** up hormone levels.
spironolactone is also no fun because it makes you piss constantly and it's exhausting. Plus your dick will go mostly limp if you're anything like me.
I really hated spironolactone.
